飞秒激光辅助板层角膜移植术切削角膜的临床观察  

Clinical observation of femtosecond laserassisted lamellar keratoplasty in cutting cornea

作　　者：孟虎[1] 陆燕[2] 葛易睿 王春红[2] 杨丽萍[2] 黄振平[1] 

机构地区：[1]南京大学医学院临床学院眼科,江苏省南京市210002 [2]南京军区南京总医院眼科,江苏省南京市210002

出　　处：《眼科新进展》2013年第12期1140-1142,共3页Recent Advances in Ophthalmology

基　　金：国家自然科学基金面上项目(编号:81270979);江苏省自然科学基金面上项目(编号:BK2012777)~~

摘　　要：目的探讨飞秒激光辅助板层角膜移植术中切削角膜的安全性。方法选取2012年4月至12月在南京军区南京总医院眼科行飞秒激光辅助板层角膜移植术的患者氉12例(12眼)为研究对象,术后1 d、2周、1个月随访,应用眼前节光学相干断层扫描技术测量角膜移植片最薄点及0°~180°经线上角膜中央及距离角膜中央-3 mm、3 mm位置上的角膜厚度,并对结果进行统计学分析。结果术后1 d植床最薄点的厚度为(148.33±49.11)μm,高于术前预留的(86.33±12.17)μm(P=0.002)。术后1 d、2周、1个月距角膜中央-3 mm位点的角膜厚度分别为(704.90±203.32)μm、(623.10±119.77)μm、(637.30±139.73)μm,角膜中央各时间点角膜厚度分别为(608.00±174.98)μm、(536.90±164.75)μm、(561.10±168.67)μm,距角膜中央3 mm位点各时间点角膜厚度分别为(732.40±151.80)μm、(665.80±129.76)μm、(649.80±138.68)μm;同一位点不同时间点间差异均具有统计学意义(F=3.91、3.76、7.05,均为P【0.05)。术后2周、1个月3个位点平均角膜厚度均较术后1 d明显减小,差异均有统计学意义(均为P【0.05),但是术后2周与1个月时3个位点平均角膜厚度差异无统计学意义(P=0.37)。结论飞秒激光辅助板层角膜移植手术安全性高,不易出现植床穿通。移植术后2周角膜水肿趋于稳定。Objective To investigate the security and changes of corneal edema after femtosecond laser-assisted lamellar keratoplasty in cutting cornea.Methods A total of 12 patients(12 eyes)in our hospital from April to December 2012 underwent femtosecond laser-assisted lamellar keratoplasty were chosen.Patients were followed up for the 1 day,2 weeks and 1 month postoperatively,the anterior segment optical coherence tomography(OCT)to used to measure corneal grafts thinnest point and corneal thickness at the central cornea and two points-3mm,3 mm distant from central on 0°-180° online cross-section,and the follow-up period thickness were statistically analyzed.Results The thickness of the thinnest point in planting beds one day after surgery was(148.33±49.11)μm,higher than the preoperative reserved(86.33±12.17)μm(P=0.002).The corneal thickness at-3 mm point at postoperative 1 day,2 weeks,1 month were(704.90±203.32)μm,(623.10±119.77)μm and(637.30±139.73)μm,respectively;The central corneal thickness at postoperative 1 day,2 weeks,1 month were(608.00±174.98) μm,(536.90±164.75)μm and(561.10±168.67)μm,respectively;The corneal thickness at 3 mm point postoperative at postoperative 1 day,2 weeks,1 month were(732.40±151.80)μm,(665.80±129.76)μm and(649.80±138.68) μm,respectively,the thickness were significantly decreased with time prolong,there were statistical differences(all P<0.05).Compared with postoperative 1 day,the corneal thickness at postoperative two weeks and one month significantly decreased(all P<0.05),but no statistical difference between postoperative two weeks and one month(P=0.37).Conclusion Femtosecond laser-assisted lamellar keratoplasty has high security,not easily penetrating planting beds.During 2 weeks after surgery cornea has significant edema,stabilized after 2 weeks.

关 键 词：飞秒激光 板层角膜移植 角膜水肿 角膜厚度 

分 类 号：R779.63[医药卫生—眼科]